Prescribing conventional antipsychotics at two Veterans Administration hospitals: are there geographical differences?

The medical records of 110 patients receiving conventional antipsychotics at two geographically distinct Veterans Administration hospitals (Syracuse, New York, and Omaha, Nebraska) were reviewed. The most common reasons for continuation of conventional antipsychotics were good response and patient or physician choice. Frequently, physicians did not discuss the reasons for continuing conventional antipsychotics or the availability of alternative therapies with their patients. Geographic differences in physicians' prescribing practices of conventional antipsychotics were apparent.     

Lesions in the Central Nucleus of the Amygdala: Discriminative Avoidance Learning, Discriminative Approach Learning, and Cingulothalamic Training-Induced Neuronal Activity

The amygdala is critically involved in discriminative avoidance learning. Large lesions of the amygdala block discriminative avoidance learning and abolish cingulothalamic training-induced neuronal activity. These results indicated that amygdalar processing is critical for cingulothalamic plasticity. The larger lesions did not allow differentiation of the specific functioning of various amygdalar nuclei. Anatomical analysis showed that damage in the central (CE) nucleus of the amygdala was correlated with the severity of the behavioral deficit. The present study was carried out to determine whether smaller lesions, centered in the CE nucleus, would impair discriminative avoidance learning and block cingulothalamic plasticity. In addition, the possible role of the CE nucleus in appetitively motivated discriminative approach learning was examined for the first time. New Zealand White rabbits with CE nuclear lesions were first trained in the discriminative approach task. After attaining asymptotic performance, discriminative avoidance training sessions were alternated with continuing approach training sessions, one session each day. The rabbits with lesions were severely impaired in avoidance learning but showed no impairment of approach learning. Surprisingly, the attenuating effects of the lesions on cingulothalamic training-induced neuronal activity were more prevalent during approach learning than during avoidance learning. These results indicated that avoidance learning can be impaired by lesions centered in the CE nucleus that leave cingulothalamic plasticity largely intact and that the CE nucleus is involved in extra-cingulothalamic learning processes.     

Stress Induced Oral Behaviors and Facial Pain

Facial pain is frequently associated with environmental stress and emotional distress. One hypothetical mechanism by which stress is translated into pain is through stress induced motor function (e.g., teeth clenching, grinding, nail biting). Existent data partially supports these stress-hyperactivity models although they have also come under theoretical and empirical attack. The purpose of this study was to examine the relationship between oral behaviors and pain in an analog sample of facial pain sufferers and student controls. Subjects engaged in a controlled clenching task and reported on subjective facial pain intensity and unpleasantness at 5 specified times over the subsequent 48 hours. A one-way ANCOVA indicated group differences in self reported oral habits (p < .05) with the facial pain group reporting great frequency of oral habits. Two repeated measures ANCOVAs (i.e., pain intensity and pain unpleasantness), controlling for baseline pain ratings, indicated a between groups effect with facial pain sufferers experiencing significantly greater pain over the 48 hours postexperiment (p < .05). This study supports a hyperactivity model of facial pain and provides clues about relevant factors in facial pain development.     

Adult attachment orientations: Relation to affiliation motivation

This study examines the multifaceted relationship between attachment and affiliation motivation. In a sample of 322 participants differences were found between attachment styles or dimensions and affiliation motivation. Anxious attachment was positively related to seeking attention from others, social comparison, and positive stimulation as motivations for affiliation. Avoidant attachment was negatively related to emotional support and positive stimulation as motivations for affiliation. Also, results indicated that individuals with a dismissing attachment style scored lower on several dimensions of affiliation motivation than individuals characterized by secure, fearful, or preoccupied attachment styles. Implications for the impact of attachment on motivation to seek social support and counseling are discussed.     

Ethnic identity and acculturation in Hispanic early adolescents: mediated relationships to academic grades, prosocial behaviors, and externalizing symptoms

This study examined acculturative stress and self-esteem as mediators of the association of ethnic identity and acculturation with psychosocial outcomes. The study sample consisted of 347 Hispanic adolescents in a "new" immigrant-receiving community in the Midwest. The authors expected acculturation to influence psychosocial adjustment through acculturative stress and ethnic identity to influence psychosocial adjustment through self-esteem. Results indicated that relationships of ethnic identity to academic grades and to externalizing symptoms were mediated by self-esteem and that both U.S. and Hispanic acculturation orientations were directly associated with prosocial behavior. The relationships of U.S. cultural orientation to academic grades and to behavior problems were mediated through acculturative stress and self-esteem. Implications of these findings for the study of Hispanics in more monocultural receiving communities are discussed.     

"Leaky" Rationality: How Research on Behavioral Decision Making Challenges Normative Standards of Rationality

ABSTRACT— For more than 30 years, decision-making research has documented that people often violate various principles of rationality, some of which are so fundamental that theorists of rationality rarely bother to state them. We take these characteristics of decision making as a given but argue that it is problematic to conclude that they typically represent departures from rationality. The very psychological processes that lead to "irrational" decisions (e.g., framing, mental accounting) continue to exert their influence when one experiences the results of the decisions. That is, psychological processes that affect decisions may be said also to "leak" into one's experience. The implication is that formal principles of rationality do not provide a good enough normative standard against which to assess decision making. Instead, what is needed is a substantive theory of rationality—one that takes subjective experience seriously, considers both direct and indirect consequences of particular decisions, considers how particular decisions fit into life as a whole, and considers the effects of decisions on others. Formal principles may play a role as approximations of the substantive theory that can be used by theorists and decision makers in cases in which the formal principles can capture most of the relevant considerations and leakage into experience is negligible.     

Remembering the forgotten: psychotherapy groups for the nursing home resident

The mental health needs of the long-term nursing home resident receive little attention. It is especially difficult for the more cognitively intact resident to obtain psychological help. An integrated group psychotherapy model that incorporates developmental, cognitive-behavioral, and psychodynamic approaches is described, based on the author's clinical experience in developing and co-leading four groups in three long-term care facilities over a period of ten years. The technical and countertransference challenges of working with this unique population and in this format are described, along with clinical material to illustrate common themes. The success of the groups in improving the morale, sense of community, and quality of life for group members is demonstrated.     

The Epidemiology of Homicide followed by Suicide: A Systematic and Quantitative Review

This systematic review of population based studies of homicide followed by suicide was conducted to examine the associations between rates of homicide‐suicide, rates of other homicides and rates of suicide. The review analysed 64 samples, including the case of an outlier (Greenland) that were reported in 49 studies. There was a significant association between the rates of homicide‐suicide and those of other homicides in studies from the U.S.A. Outside the U.S.A. there was no clear association between homicide‐suicide and other homicide but there was modest but significant association between rates of suicide and homicide‐suicide. Homicide‐suicide appears to be closer in epidemiological terms to homicide than suicide in regions with high rates of homicide and measures to reduce homicide in these regions may also reduce homicide‐suicide.     

Coping With Vicarious Trauma in the Aftermath of a Natural Disaster

This study documents the vicarious psychological impact of the 2010 earthquake in Haiti on Haitians living in the United States. The role of coping resources—family, religious, and community support—was explored. The results highlight the importance of family and community as coping strategies to manage such trauma. Este estudio documenta el impacto psicológico vicario que tuvo el terremoto de 2010 en Haití sobre los residentes haitianos que viven en Estados Unidos. Se explora el papel de los recursos de afrontamiento—apoyo familiar, religioso y comunitario. Lo resultados destacan la importancia de la familia y la comunidad como estrategias de afrontamiento para superar un trauma de esas características.